Malnutrition–Inflammation Complex Syndrome and Hepatitis C in Maintenance Hemodialysis Patients

Protein-energy malnutrition and inflammation are among the leading causes of poor outcome in hemodialysis patients. Hepatitis C virus (HCV) infection is accompanied by elevated proinflammatory mediators, also found in dialysis patients with malnutrition–inflammation complex syndrome. We aimed to study the rate and characteristics of malnutrition–inflammation complex syndrome (MICS) in hemodialysis patients, especially those with hepatitis C. The study included 147 patients (mean age 55.1 ± 12.9 years), 24.5% of whom were HCV-positive, undergoing adequate hemodialysis three times a week for the last 52.7 ± 52.5 months. Parameters of nutrition and inflammation were investigated to evaluate MICS. HCV-positive vs. HCV-negative patients had significantly higher hematocrit (29.6 ± 4.5 g/dL vs. 28.1 ± 4.3, P < 0.05), uric acid (345.8 ± 96.5 vs. 321.3 ± 118.8 µmol/mL, P < 0.05), aspartate aminotransferase (AST, also known as serum glutamic oxaloacetic transaminase [SGOT]) (23.3 ± 14.9 vs. 17.8 ± 9 U/L, P < 0.008), alanine aminotransferase (ALT, also known as serum glutamic pyruvic transaminase [SGPT]) (41.2 ± 28.7 vs. 26.6 ± 17.1 U/L, P < 0.0003), serum creatinine (980.4 ± 219.1 vs. 888.4 ± 202.9 µmol/mL, P < 0.022), intact parathyroid hormone (329.7 ± 630.5 vs. 110.2 ± 145.3 pg/mL, P < 0.002), malnutrition–inflammation score (7.4 ± 5.2 vs. 5.6 ± 4.1, P < 0.038), and Charlson comorbidity index (4.5 ± 1.5 vs. 4 ± 1.4, P < 0.05). MICS had a prevalence of 20–40% in our study. HCV-positive patients had a significantly higher prevalence of MICS than HCV-negative patients (30–40% vs. 20–30%).     

Metals in human placenta: focus on the effects of cadmium on steroid hormones and leptin

Cadmium and other metallic ions can act as metalloestrogens and endocrine disruptors of reproductive tissues and fetal development in mammals, including humans. The detrimental effects occur with respect to the synthesis of both steroid and polypeptide hormones in the placenta. Leptin is produced by the trophoblast and may regulate fetal organogenesis and development. In human term placentas, concentrations of toxic metals and their effects on steroidogenesis were assessed in healthy parturients (109 non‐smokers and 99 smokers) in relation to tobacco smoking. Trace elements (cadmium, lead, iron, zinc and copper) were analyzed in placentas using atomic absorption spectroscopy, and steroid hormones (progesterone and estradiol) were assayed in placental samples by an enzyme‐immunometric method. Cadmium concentrations were doubled in placentas of smokers as compared with non‐smokers, and placental lead and zinc concentrations increased significantly. Placental concentrations of iron, copper, progesterone and estradiol did not differ. In addition, human trophoblast cells were co‐cultured with 0, 5, 10 or 20 µm CdCl₂ for 96 h and leptin mRNA assessed by quantitative polymerase chain reaction. Leptin mRNA declined dose‐responsively as a result of CdCl₂ exposure. Collectively, the results confirm that human placental tissue offers a unique opportunity to biomonitor cadmium exposure in both the maternal and the internal fetal environments. In addition, the results strongly suggest that cadmium may cause a decline in placental leptin synthesis, as we have previously shown for placental progesterone production. This may constitute further evidence of the endocrine‐disrupting effects of cadmium, as a constituent of tobacco smoke, on reproduction in women. Copyright © 2009 John Wiley & Sons, Ltd.     

Ablative laser resurfacing: is it still the gold standard for facial rejuvenation?

A new era in dermatological cosmetology, especially in the field of nonsurgical skin rejuvenation, started with ablative resurfacing, at first by carbon dioxide laser and later by Er:YAG or their combination. Although ablative lasers result in major improvements in photodamaged skin, the related postoperative recovery time and side effects are currently unacceptable for most patients. During the last forty years, skin resurfacing has changed dramatically. After ablative laser systems, nonablative and now fractional laser systems have been developed, fulfilling the new demands for a lesser risk of side effects and minimal or no downtime.     

Cytotoxic and genotoxic effects of the quercetin/lanthanum complex on human cervical carcinoma cells in vitro

Quercetin is the main flavonoid in diet with a potential in the treatment of cancer, cardiovascular, and neurodegenerative diseases. Due to its specific planar chemical structure, quercetin readily forms chelates with metal ions. Complexes of bioactive compounds and metal ions such as lanthanum often show strong cytotoxic and antitumour properties. The aim of this study was to compare the genotoxic effects of the quercetin/lanthanum complex on human cervical carcinoma cells with compare it to the effects of free ligands, quercetin, and lanthanum alone. The quercetin/lanthanum complex showed considerable cytotoxicity in the concentration range of (100 to 1000) mmol mL-1 and exposure time of three hours. The complex also induced a dose-dependent pro-oxidative effects and the formation of single-strand and double-strand DNA breaks. Although we obtained promising results on the cell level, future experiments should answer whether the quercetin/lanthanum complex is cancer-specific and stable enough in physiological conditions to make a potential new antitumour drug.